Medial Patellofemoral Ligament Reconstruction Using Suture Tape for Patellofemoral Joint Instability

Objective To describe a surgical technique using suture tape for reconstruction of the medial patellofemoral ligament (MPFL). This technique restores the stability of the reconstructed ligament and has excellent postoperative outcomes. Method This is a retrospective analysis. From January 2016 to June 2018, 17 patients underwent MPFL reconstruction using high‐strength suture (FiberTape; Arthrex) augmentation, with at least 12 months of follow up. There were 11 female and 6 male patients. The mean age at the time of MPFL reconstruction was 22.1 years (range 13–34 years). Clinical outcomes included pain level, knee range of motion, passive patellar hypermobility, and maltracking at follow‐up. The lateral patellofemoral angles, congruence angles, and patellar tilt angles were measured in a skyline view by CT at 30° of knee flexion at 12 months. Functional outcomes were assessed using the Lysholm knee scoring scale, the SF‐12 score, the Tegner score, and the Crosby and Insall grading system at yearly follow‐up. Result No patients were lost at the last follow up. One patient had recurrence of patellar dislocation and none of the others had serious complications. The success rate of MPFL repair for preventing recurrent dislocations was 94.1% (16 of 17 knees). Fifteen knees had full range of motion of more than 130°. At follow‐up, 2 knees were judged to have mild hypermobility and none had severe hypermobility or maltracking. Using the Crosby and Insall grading system, 12 knees (70.6%) were graded as excellent, 4 knees (23.5%) as good, 1 knee (5.9%) as fair to poor, and none as worse at the last follow‐up assessment. In all patients, the Lysholm knee score (55.12 ± 13.52 vs 79.88 ± 7.50, P
Fig. 1 Measuring methods on a bradiograph. (a) 30° skyline view. (A) Lateral patellofemoral angle was defined as an angle with line (a) to (b). (B) Congruence angle was defined as an angle with line (c) to (d). (C) Patellar tilt angle was defined as an angle with line (e) to (f).Fig. 2 Intraoperative photograph of a left knee as viewed from the medial side.Fig. 3. Two suture tapes were adopted for double‐bundle medial patellofemoral ligament reconstruction and fixed by knotless anchors at the femoral side.Fig. 4. CT arthrogram postoperatively showing the position of the patella tunnel, the knotless anchor, and the patella at the patellofemoral joint.